The role of demographics, social deprivation and ethnicity on anal squamous cell carcinoma incidence in England
File(s)
Published version
Author(s)
Kontovounisios, Christos
Type
Journal Article
Abstract
Anal Squamous Cell Carcinoma (ASCC) is an HPV-related malignancy with increasing
incidence in high-income economies. Although ethnicity and social deprivation are known to be
risk factors in other malignancies, little is known about socioeconomic status and risk of ASCC.
This is a cross-sectional study following the STROBE Statement. Demographic data from the English Clinical Outcomes and Services Dataset (COSD) were extracted for all patients diagnosed with
ASCC in England between 2013 and 2018. Outcomes included ethnicity, social deprivation, staging and treatment. This study included 5457 patients. Incidence increased by 23.4% in 5 years,
with female incidence increasing more rapidly than male incidence (28.6% vs. 13.5%). Men were
more likely to present with early staging (p < 0.001) and have surgery as their only treatment (p <
0.001). The rate of incidence of Stage 1 tumours in men was 106.9%; however, women had the
greatest increase in metastatic tumours (76.1%). Black Caribbean and Black African patients were
more likely to present at an earlier age with later staging (p < 0.001) and social deprivation was
associated with younger age (p < 0.001). ASCC incidence is rapidly increasing in patterns consistent with two separate populations: one male with early staging, the other female and related to
social deprivation and ethnicity factors.
incidence in high-income economies. Although ethnicity and social deprivation are known to be
risk factors in other malignancies, little is known about socioeconomic status and risk of ASCC.
This is a cross-sectional study following the STROBE Statement. Demographic data from the English Clinical Outcomes and Services Dataset (COSD) were extracted for all patients diagnosed with
ASCC in England between 2013 and 2018. Outcomes included ethnicity, social deprivation, staging and treatment. This study included 5457 patients. Incidence increased by 23.4% in 5 years,
with female incidence increasing more rapidly than male incidence (28.6% vs. 13.5%). Men were
more likely to present with early staging (p < 0.001) and have surgery as their only treatment (p <
0.001). The rate of incidence of Stage 1 tumours in men was 106.9%; however, women had the
greatest increase in metastatic tumours (76.1%). Black Caribbean and Black African patients were
more likely to present at an earlier age with later staging (p < 0.001) and social deprivation was
associated with younger age (p < 0.001). ASCC incidence is rapidly increasing in patterns consistent with two separate populations: one male with early staging, the other female and related to
social deprivation and ethnicity factors.
Date Issued
2021-08-17
Date Acceptance
2021-08-12
Citation
Journal of Clinical Medicine, 2021, 10 (16), pp.1-11
ISSN
2077-0383
Publisher
MDPI AG
Start Page
1
End Page
11
Journal / Book Title
Journal of Clinical Medicine
Volume
10
Issue
16
Copyright Statement
© 2021 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/)
License URL
Identifier
https://www.mdpi.com/2077-0383/10/16/3621
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Anal Squamous Cell Carcinoma
HIV
chemoradiotherapy
ethnicity
socioeconomic status
HPV
SOCIOECONOMIC INEQUALITIES
CANCER-DIAGNOSIS
GUIDELINES
COLON
EPIDEMIOLOGY
ASSOCIATION
STAGE
Anal Squamous Cell Carcinoma
HIV
HPV
chemoradiotherapy
ethnicity
socioeconomic status
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2021-08-17